Jan. 30, 2013

Ribble

Ribble, R-Sherwood, met with a small group at a private event at the Radisson Paper Valley Hotel to ask questions about barriers to care and get reactions to potential legislation.

“When you’re dealing with complex issues, the key is to slow down,” Ribble said. “The American people are anxious for some decisions and politicians are anxious, but that’s how bad decisions get made.”

Ribble, who met earlier with police chiefs from the Fox Valley, asked both groups about creating a national database of mentally ill individuals, which the National Rifle Association floated after the Sandy Hook shooting.

Dr. Larry Donatelle, vice president of medical affairs at St. Elizabeth Hospital, said that task could be unattainable.

“There’s such a broad spectrum of mental health — and trying to identify individuals that are ‘at-risk’ seems almost insurmountable,” Donatelle said. “It’s difficult to draw a line that if you cross over, you’re a risk to society.”

Much of the roundtable discussion centered on stigmas and access to mental health care.

Matthew Stanford, vice president of policy affairs for the Wisconsin Hospital Association, said mental health is treated differently than physical health on many fronts.

“In Wisconsin, in order to get an emergency detention, it’s not a physician making that decision,” Stanford said. “It has to be a law enforcement officer and a county crisis officer — even though it’s a medical issue.”

Physicians and therapists at the event said state and federal law inhibit sharing of information that would lead to more comprehensive care for mental health.

Dr. John Mielke, an Appleton cardiologist, said mental health should be treated more like a medical disease and less like a stigmatized behavioral condition.

“As a cardiologist, we don’t have problems identifying and working with specialists and primary care doctors,” Mielke said. “We have stigmatized mental health. Think of a student in an elementary school; he can go to the health room for (an) abrasion, but where does the kid with anxiety go? He needs to get help in a different place.”

Dave Vander Zanden, a board member of Catalpa Health, spoke about the organization’s effort to screen students in Fox Valley schools.

“There’s a real solution that could be replicated all over,” Vander Zanden said. “It screens for mental health at an early age and gets help and treatment, but as with almost every issue, it comes down to money.”

Others on the panel lamented financial pressures that often curtail care for mental health services.

Stanford pointed out that mental health treatment skews to lower-income individuals, which means a higher share of Medicaid payment and fewer reimbursements for hospitals.

“Mental health providers see a higher number of folks on Medicaid, than say a family practice physician,” Stanford said. “Then you see Medicaid paying below costs for the services, and put providers in a pinch.”